How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $2,754.23 Median $4,466.84 Typical High $7,585.78 | Facility | None | $2,754.23 | $4,466.84 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $208.93 Typical High $251.19 | Professional | None | $141.25 | $208.93 | $251.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $794.33 Median $2,691.53 Typical High $7,762.47 | Facility | None | $794.33 | $2,691.53 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $138.04 Median $190.55 Typical High $288.40 | Professional | None | $138.04 | $190.55 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $169.82 Typical High $501.19 | Facility | None | $51.29 | $169.82 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $251.19 Typical High $380.19 | Professional | None | $204.17 | $251.19 | $380.19 |
ConnectiCare Setting Professional Modifier None Typical Low $158.49 Median $208.93 Typical High $251.19 | Professional | None | $158.49 | $208.93 | $251.19 |
Health New England Setting Facility Modifier None Typical Low $398.11 Median $489.78 Typical High $912.01 | Facility | None | $398.11 | $489.78 | $912.01 |
Health New England Setting Professional Modifier None Typical Low $144.54 Median $478.63 Typical High $660.69 | Professional | None | $144.54 | $478.63 | $660.69 |
United Setting Facility Modifier None Typical Low $251.19 Median $1,548.82 Typical High $4,466.84 | Facility | None | $251.19 | $1,548.82 | $4,466.84 |
United Setting Professional Modifier None Typical Low $109.65 Median $199.53 Typical High $436.52 | Professional | None | $109.65 | $199.53 | $436.52 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $75.86 Median $104.71 Typical High $120.23 | Professional | 52 · Reduced service | $75.86 | $104.71 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $41.69 Typical High $47.86 | Professional | 53 · Discontinued | $30.90 | $41.69 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $158.49 Typical High $181.97 | Professional | 54 · Surgery only | $114.82 | $158.49 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $31.62 Typical High $36.31 | Professional | 55 · Aftercare only | $22.91 | $31.62 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $20.89 Typical High $23.99 | Professional | 56 · Pre-op care only | $15.14 | $20.89 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $147.91 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $107.15 | $147.91 | $169.82 |
Where Connecticut sits
The same service costs 3.9 times more in Alaska than in Florida. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Connecticut· 12th of 51
$214
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.